ICP-CBF
Research type
Research Study
Full title
Investigating the relationship between intracranial pressure and cerebral blood flow using near-infrared diffuse correlation spectroscopy
IRAS ID
317751
Contact name
Christopher E G Uff
Contact email
Sponsor organisation
Barts Health NHS Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Cerebral Autoregulation (CA) is the complex process whereby the body maintains oxygenation and nutrition of cerebral tissue (essentially “the brain”). By balancing blood and cerebrospinal fluid (CSF) pressures, CA dynamically stabilises cerebral perfusion pressure (CPP) and hence blood flow. Failure of CA can reduce oxygen and nutrient delivery to the brain leading to significant morbidity and mortality.
Instability and extremes of intracranial pressure (ICP) are associated with failing CA. Hence ICP is routinely monitored in patients suffering from traumatic brain injury and other conditions which may result in CA failure. Raised ICP is present in the majority of mortalities following severe TBI. Standard ICP monitoring requires insertion of a cranial bolt into the skull through which an electrical transducer is inserted. Alternatively an intra-ventricular catheter is inserted through a burr hole.
This project pilots an approach to expand our understanding of the basic physiological interplay between intracranial pressure, arterial blood pressure, and cerebral blood flow in adult patients.
A recently-developed research technology known as Diffuse Correlation Spectroscopy (DCS) offers an opportunity to investigate cerebral blood flow at the bed-side continuously. DCS measures blood flow in the brain microvasculature non-invasively using low levels of near-infrared light.
The interplay between mean arterial blood (MAP) and ICP affects the morphology of the pulsatile flow in the cerebral microvascular, so the analysis of these signals in unison will help us better understand the relationship between ICP (which is measured clinically), MAP (which is measured clinically) and cerebral blood flow (which is not). This in turn could help support new research into head injury management, notably ICP-targeted treatment regimes. Ultimately this could lead to significant improvements in secondary injury-related mortality, length of hospital stay and improved patient outcomes.
Summary of study results:
A novel method for estimating intracranial pressure through diffuse correlation spectroscopy was trialled.
It was shown to be safe and feasible to acquire data however the data in their current form were not able to be used to estimate intracranial pressure without significant further work on the research instrument.
Further clinical trials are planned once technological progress has been made.REC name
London - South East Research Ethics Committee
REC reference
22/LO/0825
Date of REC Opinion
15 Nov 2022
REC opinion
Favourable Opinion